Selçuk Tıp Dergisi Arşiv

This study was undertaken to examine effects of pinealectomy and pinealectomy followed by melatonin adminis- tration on thyroid gland. For this purpose 18 male VVistar rats were used. Animals were divided into three groups. Group I and II were designated as sham-pinealectomized (control) and pinealectomized, respectively. The rats in Group III were pinealectomized and daily injected with melatonin for 1 month. At the end of the experiment, ali animals were killed by vascular perfusion. The thyroid glands of rats were removed, then some of the thyroid tissue specimens were stained with AgNOR techniçue and examined by light microscopy. AgNOR numbers in nuclei of thyroid follicular cells were counted. Some of the tissue specimens were examined by electron microscopy. İn our study, some findings proving the increase of mitoz activation along with the increase in the number of AgNOR granules in celi nuclei of thyroid epithel were observed after pinealectomy. Furthermore, lizozomes and secretory granules in the cytoplasm of thyroid follicular cells were increased. İn the melatonin injected group, the number of AgNOR granules in celi nuclei were decreased. Additionally, ultrastructural changes, which indicate the increase of celi activation and is visible in thyroid epithel cells after pinealectomy were disappeared follovving injection of melatonin. İn conclusion, it was observed that there has been an increase in thyroid epithel celi proliferation and in celi activation after pinealectomy and this increase has been reversed by melatonin injection.

Objective: To evaluate the relations among the critical power, maximal oxygen utilization and anaerobic thresh- olds. Method: İn order to determine the maximal oxygen consumption and anaerobic thresholds on 30 sedentary men aged 18-22 years, an incremental maximal exercise test on cycle ergometer was performed. Respiratory gas parameters were recorded by SensorMedics 2900 Metabolic Measurement Cart in every 20, heart rate values were recorded by Polar Sport Tester in every 5 seconds and blood lactate concentrations were determined by Accusport Lactate Analyzer on capillary blood samples from fingerpoint at the end of every two minutes. From the gas exchange parameters and heart rate and lactate values, three separate ventilatory thresholds, heart rate deflection point and the onset of blood lactate accumulation were calculated. Three different loads were applied for the critical power test at different days and linear work-time relationship method was used to estimate the crit­ ical power. Each participant performed an exercise test at his critical power until exhaustion and then the duration of exercise and work were determined. Results: İt was found that the critical power was correlated with VO2max and some anaerobic thresholds. The critical power was lower than the load at which VO2max was occurred, but higher than the loads at which anaerobic thresholds were occurred. The duration of exercise and work at the crit­ ical power were not correlated with VO2max and anaerobic thresholds. Conclusion: Although the critical power is related to the maximal aerobic power and some anaerobic thresholds, we consider that duration of exercise and work at the critical power can not be used as criteria in the determination of endurance since exercise time and work at the critical power are not correlated to these endurance parameters.

Patients with acute rheumatic fever, who were admitted to Pediatric Cardiology Unit of Selçuk University Meram Faculty of Medicine, were studied ret- rospectively to verify the clinical and laboratory profile of the disease. 395 cases were identified among patients admitted to the present institution. Age on admission was 5-18 years (mean 11.3±2.8), they were 213 (53.9%) boys, and 182 (46.1%) giriş. Manifestations included carditis 70.3°%, arthritis 66.5°%, Sydenham’s chorea 22.2%, eritema marginatum 1 °%,subcutaneous nodules 0.7%. Pericardial effusion was occurred in 3.5°%. Mitral insuffi- ciency and aortic insufficiency and aortic insufficiency were occurred in 95.3°% and 46.4°%, respectively. The regur- gitation disappeared in 23.6°% and 33°% of patients with mitral and aortic regurgitation, during follow-up. The caus- ing recurrence was the non-compliance with penicillin prophylaxis.

The purpose of this study was to evaluate the fear, vvorry and axieties of patients about anesthesia and surgery preoperatively by using a questionaire, and to measure their anxiety by using visual analogue scale (VAS). Five hundred and thirty six patients (>19 yr of age) were questioned about their worries, fears and request of Infor­ mation by means of a questionaire. The ansvvers were analysed with chi-square and correlation tests and p<0.05 was considered as significant. Fear from surgery was higher in the less educated patients (p<0.05). VVomen feared from anesthesia and surgery more than men (p=0.0001). Men prefered local anesthesia more than vvomen (p=0.00165). Fear and request of Information increased with increased income (p=0.01). VAS scores vvere high­ er in vvomen, illeterate and primary school graduates, and patients vvithout previous surgical or anesthesia expe- rience (p<0.05). No correlation was present betvveen VAS scores and income or increase or decrease of Informa­ tion requests (p>0.05). İt was concluded that not ali but some patients feared of surgery or anesthesia or vvanted Information. Informing these patients on the consequences of anesthesia and surgery may be usefull in alleviating their fears or vvorries. Positive correlation betvveen the results of the questionaire and VAS scores, leads us to con- sider that VAS scores may be usefull for measuring preoperative anxiety.

The study compares the recovery charecteristics of desflurane and isoflurane in children undergoing tonsillectomy and/or adenoidectomy. Forty children 4-12 year of age were studied and thirty minutes prior to the induction of anesthesia, ali patients received 0.5 mg/kg midazolam orally. They were randomly assigned to receive 1-1.5 % isoflurane (group I) and 6-7 % desflurane (group II) for maintenance of anesthesia afterpatients given 2-2.5 mg/kg propofol and 10 pg/kg alfentanyl for anesthesia induction. Before surgery, patients received 20 mg/kg paracetamol rectally for postoperative analgesia. Dexamethasone 150 pg/kg was given to reduce the incidence of postoperative nausea and vomiting. Administration of anesthetic agents was terminated at the end surgery. At the end of operation extubation and recovery time determined. Extubation time was defined as the time from discontinuation of anesthetics to extubation. Recovery time was measured from the time the anesthetics were discontinued until the patients achieved a score of 8 on the Aldrete score. Agitation was evaluated by using the three-point score. Extubation and recovery time were significantly faster in the desflurane group than isoflurane group (p<0.05). İncidence of agitation was similar for both groups. As a result, desflurane provides a faster recovery than isoflurane in short-term surgery on children.

Trauma is stili an important mortality and morbidity cause among the young population in the world. Therefore, trauma should be seriously considered in view of medical and social factors. İn this study, it was aimed to inves- tigate the types of trauma in respect to reasons, and to provide data to epidemiologic Information of our country. Between January 1999 and December 1999, totally 2850 cases with trauma [(2051 male (72%) and 799 female (28%)] applied to Emergency Department of Selçuk University, Meram Medical Faculty, were analyzed retro- spectively. AH cases were evaluated according to their sex, age, type of trauma, time of trauma, the duration betvveen the onset of trauma and application time to the Emergency Service, and type of transportation. 2332 (82%) of cases were aged betvveen 0 and 40 years. 1593 (55.9%>) of the cases had trauma due to car-crush. Only 885 cases (31.1 %) were transferred to Emergency Service vvithin 1 hour. Most of the trauma occurred on Sundays (n=467, 16.4%), and in June (n=342, 12%>). The most frequent reason of the trauma was found to be fail (50.5%). İt was concluded that, in the organisation of trauma, the vvounded subject should be transferred to the nearest trau­ ma çenter, according to the degree of his/her trauma.

Objective: İn developed populations the increasing trend of electromagnetic pollution survives in an insidious and dangerous dimension. Although estimating the negative effects of electromagnetic field on human organism is very difficult, assessment of their effect on arteries was aimed in this experimental study. Material and Methods: An electrical shaver was choosen as a source of electromagnetic field which was estimated as having a 5-10 gauss electromagnetic field. The shaver was directly performcd on skins of left common carotid and bilateral femoral arteries of 7 Street dogs, weighing meanly 20-25 kg, vvithin a mean period of5months. This was performed on one time in every week with a period of 7 minutes. Totally, 18 periods were performed. At the end of the study carotid and femoral arteries were excised for histopathological examination. Results: Tissue examples of 21 study and 14 control specimens were examined under light microscope. İn study group 8 examples had moderate and 7 examples had severe intimal changes, while in control group 3 examples had mild intimal changes. A chi square test between these groups were considered significant (p<0,05). Conclusion: Endothelial injury and subendothe- lial seperations were significantly found in a very short period. These changes may cause stroke due to athero­ genesis on carotid arteries in a longer period.

Betvveen the period December 1999 and February 2001, 93 women who undervvent excision biopsy of the breast were included into a controlled randomized trial to determine the effect on postoperative morbidity and hospital stay of drainage of the biopsy cavity. Among the 93 patients, drain was used in 45 (group I) and 48 (group II) had no drain. The vvounds were examined seven days after operation vvith ultrasonography. Collections such us haematoma or seroma were present in 41 (%91.1) patients with undrained vvounds compared with 39 (%81) patients wuth drained vvounds. Median collection volüme was 30.67 ml±24.87 (SD) (range 0-140) in the undrained group and 25.00±16.47 mİ (SD) (range 0-80) in the drained group. There vvas one infection (% 2.2) in undrained group and two (% 4.1) in drained group. While there vvas no significant difference betvveen two groups in terms of vvound infection and seroma (p>0.05), the length of hospital stay vvas statistically longer in drainage group (p<0.01). We conclude that breast biopsy cavity drainage with penrose drain, does notprevents vvound collections and infections.

Diabetic muscle infarct is a rare complication of type 1 insulin dependent diabetic patient, resenting with focal thigh pain, tenderness, swelling and erythema. These pathologic findings were observed in 72 years old male patient, 5 days after he was accepted to our clinic because of diabetic foot ulcer. The mass was thought that on abscess at first but unixue extensor hallucis muscle infarct was observed by surgical exploration.Necrosed muscle was excised and defect area was reconstructed with split thickness skin graft. V/e have presented a case of extensor hallucis longus muscle infarction in a diabetic patient first in the literatüre.

Aim: To present a case in which the umbilical cord has the abnormality of including a single umbilical artery. Case report: The patient was 30 years old, has passed 6 pregnancy, 1 parturition, 4 abortions and has none alive children. At the 36 gestational week she was admitted to the clinic of obstetrics and gynecology and the patient was diagnosed as in utero ex fetus. After parturition of the dead fetus, placenta and the infant’s umblical cord was sent to the the clinic of pathology for examination. During the examinations, the absence of the right umbilical artery was determined. İn histopathologic investigation brain tissue congestion and vascular dilatation in places, necrosis areas, intestinal mucosa and liver necrosis and ali organs congestion have seen. Pathologic findings include lesions because of ischemic tissue perfusion insufficiency. Results: The abnormality of a single umbili­ cal artery especially the absence of right umbilical artery is rare. The abnormalities of umbilical cord are diag­ nosed easily during prenatal period by using doppler ultrasonography. The cases in which are diagnosed umbili­ cal cord abnormalities must be examined for chromosome abnormalities and congenital malformations.

Multiple intracerebral hemorrhage represents 2 % of ali intracranial hemorrhages. Multiple intracerebral hemor- rhages have been known to occur most frequently in patients with coagulation defects, neoplasms, angiopathies or sinüs thrombosis. The finding of recurrent intracerebral hemorrhages is not unusual in patients with systemic arterial hypertension, but simultaneous occurence of multiple hemorrhages is rare in these patients. However, multiple spontaneous intracerebral hemorrhages vvithout an identifiable etiology were also reported in the literatüre. Here, we describe a hypertensive patient who developed multiple intracerebral hematomas. The patient had bilateral thalamic hematoma that extended the lentiform nucleus. There was apathy, loss of emotional concern, upvvard gaze palsy, tetraparesis and hypertensive retinopathy in the neurologic examination. Conditions other than hypertension that might cause intracerebral hemorrhage were excluded by laboratuary investigations.

Interrupted aortic arch is defined as a complete separation of ascending and descending aorta. Our patient was classified type B whose interruption was between the left common carotid and subclavian arteries. Type B interrupted aortic arch associated with other extracardiac and intracardiac congenital lesions is a lethal defect. However, interruption of the aotic arch in association with ventricular inversion, hypoplastic left ventricul and double inlet left ventricul is a very rare condition. We report one case whose survival was provided by primary cardiac repair.